Pathology/Lab Coding Alert

Question: A cardiologist ordered "CVD markers" for a patient presenting with chest pain. What test(s) do these refer to, and how should we code them?

Pennsylvania Subscriber

Answer: CVD markers refer to lab tests that could be an indicator for cardiovascular disease. The term does not encompass a specific test or set of tests, however, so you could not accurately perform lab tests or bill for them based on this information alone.

The lab should contact the cardiologist to get specific orders for the desired tests. For instance, the physician might request a brain natriuretic peptide (BNP) test for a patient with chest pains to evaluate the prognosis of a current cardiovascular event. If the lab performs BNP, you would bill 83880 (Natriuretic peptide).

The cardiologist might also order a C-reactive protein (CRP) test to evaluate inflammation that's related to heart disease risk. If the lab performs that test, you should report 86140 (C-reactive protein).

Bottom line: The term "CVD markers" does not provide enough specific information for ordering or billing lab tests. Once you ascertain the specific tests that the cardiologist orders for the patient, you should bill the lab tests accordingly.